Logic and Logistics of Monitoring Large Bowel Cancer
There is still a general dissatisfaction with the results of surgery for the treatment of large bowel cancer; the overall 5-year survival rate for resectable tumors is approximately 40% (Rhoads, 1975; Silverberg and Hollet, 1974). This survival rate has remained static for many years in major hospitals with extensive experience in this disease. Chemotherapy has had a limited success so far; many adenocarcinomas of the bowel have been shown to be relatively resistant to the drugs available, although short-term palliation is not too difficult to obtain, the more recent forms of combination chemotherapy perhaps giving ground for cautious optimism (Carter, 1976). Nevertheless, it looks as if for the next few years we must place our hopes in chemotherapy to aid surgery. The problem then is to find the right combination of drugs, dose, and timing to suit the individual patient and his particular tumor. Current knowledge suggests that chemotherapy will have the best chance of being effective when the tumor load is small. This in turn has created a greater demand for aids to identify patients with a high risk of recurrence after surgery and systems to monitor the patient after excision of a primary tumor of the large bowel, as well as helping to assess the response of a tumor to therapy.
KeywordsColorectal Cancer Rectal Cancer Large Bowel Hepatic Metastasis Carcinoembryonic Antigen
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- Bacchus, H., 1975, Serum glycoproteins in cancer, Progr. Clin. Pathol. 6: 111–135.Google Scholar
- Baden, H., Anderson, B., Augustenborg, G., and Hanel, H. K., 1971, Diagnostic value of γ glutamyl transpeptidase and alkaline phosphatase in liver metastases, Surg. Gynal. Obstet 133: 769–773.Google Scholar
- Booth, S. N., King, J. P. G., Leonard, J. C., and Dykes, P. W., 1974b, The significance of elevation of serum carcinoembryonic antigen (CEA) levels in inflammatory disease of the intestine, Scand. J. Gastroenterol. 9: 651–656.Google Scholar
- Cooper, E. H., 1967, Enzymes in bladder tumors, in: Scientific Foundations of Virology ( D. I. Williams and G. D. Chisholm, eds.), pp. 322–325, Heinemann, London.Google Scholar
- Cooper, E. H., Turner, R., Geekie, A., Neville, A. M., Goligher, J. C., Graham, N. G., Giles, G. R., Hall, R., and MacAdam, W. A. F., 1976a, Alpha globulins in the surveillance of colorectal cancer, Biomedicine 24: 174–178.Google Scholar
- Dukes, C. E., 1960, The pathology of rectal cancer, in: Cancer of the Rectum ( C. E. Dukes, ed.), pp. 59–68, Livingstone, Edinburgh.Google Scholar
- Galen, R. S., 1975, Multiphasic screening and biochemical profiles: State of the art, Progr. Clin. Pathol. 6: 83–110.Google Scholar
- Gérard, A., 1975, Carcinoma of the colon and rectum: Prognostic factors in cancer therapy, in: Prognostic Factors and Criteria of Response ( M. J. Staquet, ed.), Raven Press, New York.Google Scholar
- Koj, A., 1975, Acute phase reactants, in: Structure and Function of Plasma Proteins, Vol. I ( A. C. Allison, ed.), pp. 73–132, Plenum, New York.Google Scholar
- Silverberg, E., and Hollet, A.I., 1974, Cancer statistics 1974—Worldwide epidemiology, Cancer 24: 1–64.Google Scholar